1
Q
fluoxetine: class
A
- SSRI
2
Q
difference b/w TCAs and SSRIs
A
- SSRIs are equally effective, better tolerated, and safer
3
Q
fluoxetine: indications
A
- major depressions
- OCD
- panic disorder
- PMDD
- bulimia nervosa
- unlabeled: PTSD, social phobia, alcoholism, ADHD, micgraine, tourette’s
4
Q
fluoxetine: MOA
A
- SSRIs selectively block neuronal reuptake of serotonin (5HT)
- so the conc of 5HT in the synapse inc and causes inc activation of 5HT receptors
- relief of depression takes several weeks to fully develop even though receptors blocked w/in hours
5
Q
fluoxetine: SE
A
- sexual dysfunction: impotence, delayed/absent orgasm, delayed/absent ejaculation, dec sexual interest)
- rash
- nausea
- headache
- weight gain
- CNS effects: drowsiness, insomnia, anxiety
6
Q
fluoxetine: ADRs
A
- neuroleptic malignant syndrome
- seizures
- suicidal thoughts
- Torsades de Pointes
- serotonin syndrome
- neonatal effects:
- neonatal abstinence syndrome
- persistent pulmonary HTN of the newborn (PPHN)
- VSD
- GI bleed
7
Q
what is serotonin syndrome?
A
- starts 2-72 hours after taking an SSRI
- S/S:
- altered mental status
- incoordination
- myoclonus
- hyperreflexia
- excessive sweating
- tremor
- fever
- may cause death
8
Q
what is neonatal abstinence syndrome?
A
- withdrawal syndrome in newborn
- S/S: irritability, abnormal crying, tremor, respiratory distress, seizures
9
Q
what is PPHN?
A
- persistent pulmonary HTN of the newborn
- risk of death
- among survivors: cognitive delay, hearing loss, neurologic abnormalities
- tx: ventilation, O2 and NO, IV sodium bicarb
10
Q
SSRIs: nursing implications
A
- contraindicated: pts taking MAOIs
- caution in pregnant patients and older adults
- make sure to take meds as prescribed even if feel cured
- should continue 4-9 mos
- usually take 1-3 weeks for effects to develop
- administer in the morning to minimize sleep problems
- take with food to minimize GI upset
- do not d/c abruptly
11
Q
paroxetine: class
A
- SSRI
12
Q
paroxetine: indcations
A
- major depression
- OCD
- panic disorder
- social phobia
- GAD
- PTSD
- PMDD
13
Q
- paroxetine: MOA
A
- SSRIs selectively block neuronal reuptake of serotonin (5HT)
- so the conc of 5HT in the synapse inc and causes inc activation of 5HT receptors
- relief of depression takes several weeks to fully develop even though receptors blocked w/in hours
14
Q
paroxetine: SE
A
- nausea
- somnolence
- sweating
- tremor
- fatigue
- headache
- weight gain
- sexual dysfunction
- CNS stimulation: insomnia, inc waking
- antimuscarinic effects
15
Q
paroxetine: ADRs
A
- neuroleptic malignant syndrome
- seizures
- suicidal thoughts
- Torsades de Pointes
- serotonin syndrome
- neonatal effects:
- neonatal abstinence syndrome
- persistent pulmonary HTN of the newborn (PPHN)
- VSD
- GI bleed
16
Q
sertraline: class
A
- SSRI
17
Q
sertraline: indications
A
- major depression
- OCD
- panid disorder
- social phobia
- PTSD
- PMDD
- off label: GAD
18
Q
sertraline: MOA
A
- SSRIs selectively block neuronal reuptake of serotonin (5HT)
- so the conc of 5HT in the synapse inc and causes inc activation of 5HT receptors
- relief of depression takes several weeks to fully develop even though receptors blocked w/in hours
19
Q
sertraline: SE
A
- headache
- CNS stimulation: insomnia, agitation, nausea, diarrhea, tremor
- weight gain
- sexual dysfunction
20
Q
sertraline: ADRs
A
- neuroleptic malignant syndrome
- seizures
- suicidal thoughts
- Torsades de Pointes
- serotonin syndrome
- neonatal effects:
- neonatal abstinence syndrome
- persistent pulmonary HTN of the newborn (PPHN)
- VSD
- GI bleed
Pharmacology Test 3
flashcards
Decks in class (10)
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